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Prognostic factors in patients with locally advanced head and neck cancer treated with concurrent radiochemotherapy

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Abstract

Purpose

This study was undertaken to evaluate the association of individual parameters and outcome in patients with unresectable locally advanced head and neck cancer treated with radiochemotherapy.

Materials and methods

We retrospectively reviewed data from 126 patients treated in our Institution between 1998 and 2010 for a locally advanced head and neck cancer. Sixteen individual parameters were evaluated for association with specific outcomes such as overall survival, persistence of disease, disease-specific survival and disease-free survival.

Results

Six factors influenced overall survival on Kaplan–Meier survival analysis and on univariate Cox regression analysis: smoking, body mass index, site, haemoglobin (Hb) nadir, total dose of radiotherapy and comorbidities. On a multivariate logistic model with stepwise selection, comorbidities, body mass index, total dose and site maintained significance. A significant association for persistence of disease was found with smoking, Hb nadir and site of cancer on univariate and multivariate analysis. Disease-free survival was correlated with performance status, Hb nadir and comorbidities using Kaplan–Meier survival analysis and on univariate Cox regression analysis. Only performance status maintained the significance on multivariate analysis. Disease-specific survival was correlated with five parameters: body mass index, site, Hb nadir, therapy interruption and total dose; on multivariate analysis, Hb nadir, therapy interruption and site maintained a statistically significant association.

Conclusions

Hb nadir during treatment, body mass index, smoking, stage, comorbidities and performance status are prognostic factors of outcome and response to radical treatment with radiochemotherapy.

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Authors and Affiliations

  1. Department of Radiation-Oncology, University of Florence, Florence, Italy

    Davide Franceschini, Fabiola Paiar, Pierluigi Bonomo, Benedetta Agresti, Icro Meattini, Daniela Greto, Monica Mangoni, Fiammetta Meacci, Mauro Loi, Giacomo Zei, Lorenzo Livi & Giampaolo Biti

  2. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Center (ISPO), Florence, Italy

    Calogero Saieva

  3. Department of Radiotherapy, University of Florence, Largo G.A. Brambilla 3, 50134, Florence, Italy

    Davide Franceschini

Authors
  1. Davide Franceschini
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  2. Fabiola Paiar
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  3. Calogero Saieva
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  4. Pierluigi Bonomo
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  5. Benedetta Agresti
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  6. Icro Meattini
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  7. Daniela Greto
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  8. Monica Mangoni
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  9. Fiammetta Meacci
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  11. Giacomo Zei
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  12. Lorenzo Livi
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  13. Giampaolo Biti
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Correspondence to Davide Franceschini.

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The authors declare no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Franceschini, D., Paiar, F., Saieva, C. et al. Prognostic factors in patients with locally advanced head and neck cancer treated with concurrent radiochemotherapy. Radiol med 121, 229–237 (2016). https://doi.org/10.1007/s11547-015-0586-1

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  • DOI: https://doi.org/10.1007/s11547-015-0586-1

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